Clinical training: Creating the sales force of the future

I recently chaired a conference on developing thought leader and key opinion leader relationships, and one subject of discussion was who owns KOL relationships. From a field perspective, sales representatives and medical science liaisons are main points of contact for physicians. Many companies are expanding MSL teams, hiring professionals with doctorates to build peer-to-peer relationships with thought leaders. Some have positioned MSLs as a gateway for representatives to access no-see physicians. Medical science liaisons are not incentivized by sales goals, but current trends cause many to wonder if MSLs are supplanting today’s representatives and becoming the “sales force of the future.”

Market research studies like those in Medical Meetings and Physicians Practice magazines have documented physicians’ backlash against today’s sales representatives, who are often viewed as inexperienced, intrusive and frequently biased. The reach-and-frequency model has degenerated into sample drops and 30-second product pitches. Representatives are no longer granted adequate opportunity to determine what information may be valuable to their customers, which in turn perpetuates a perception that representatives waste doctors’ time.

While industry experts debate the sales force arms race, some companies have begun deploying MSLs to compensate for the effects of inadequate clinical training programs for representatives. Old habits die hard. We may not see a reduction of sales forces anytime soon, and many companies are now ramping up liaison teams and imposing reach-and-frequency requirements for MSLs. The path to a potentially disastrous denouement is shortened by increased participation of community-based physicians in clinical trials, pressure for companies to train sales representatives for record-time deployment and continued ambiguity around the role of MSLs in the pharmaceutical organization. Blurring of thought leader “segments” visited by sales reps and medical liaisons has led some MSLs to see their role as that of “glorified sales representatives” and, worse, “off-label sales representatives.”

Different opinion leaders

The clinical concerns of sales representatives’ thought leaders are often very different from those of liaisons’ thought leaders. Representatives’ physicians are balancing a precarious mix of efficient patient care and effective business practice. Primary care doctors and specialists must balance innovation against their ability to support complex regimens for a large number of patients. Medical science liaisons’ opinion leaders are often academics whose reputations are driven by research innovation, policy making and high-level educational initiatives. These physicians are interested in obscure data and new hypotheses, and work with patients in the highly controlled environment of clinical trials. In the context of these very different thought leader segments, representatives help their physicians compartmentalize new information to allow for quick and effective decision making. Liaisons engage their physicians in comprehensive scientific discourse to encourage medical innovation.

Increased sales force effectiveness may be attained in part by improving clinical training programs for sales representatives. Clinical training is generally mixed into traditional sales training, which rarely affords representatives an appropriate foundation for true scientific competence. Representatives who come from a healthcare background may find their experience adequate compensation for a less-than-robust clinical training program. For representatives who do not have prior healthcare experience or a scientific background, company sales training may not provide the clinical competence needed to move beyond a scripted sales call. Pharmaceutical companies have provided representatives with pithy product messages and memorable answers to objections. However, these structured sound bites are not conducive to uncovering physicians’ concerns and have become transparent as biased sales messages.

The sales representative job is one of the toughest. I was a pharmaceutical sales representative, and I know firsthand the challenges that come with carrying the bag. Today’s sales representatives need support to achieve a level of clinical confidence that enables them to become trusted partners with physicians. Thus, effective and adequate clinical training is as much a necessity for representatives as selling skills. Rather than forcing rote memorization of advanced scientific concepts, companies should improve clinical pedagogy.

Sales representatives and medical science liaisons should have clear and independent roles. Each field-based profession is necessary for short-term and long-term growth of a pharmaceutical company. Sales representatives should not be treated as if their profession were broken, such that another profession is dispatched to compensate. Medical science liaisons are not, and should not be, the sales force of the future. Clinically competent, scientifically confident sales representatives are the sales force of the future.